A 21-year old female (A.M.) presents to the urgent care clinic with symptoms of nausea, vomitin

A 21-year old female (A.M.) presents to the urgent care clinic with symptoms of nausea, vomiting, diarrhea, and a fever for 3 days. She states that she has Type I diabetes and has not been managing her blood sugars since she’s been ill and unable to keep any food down. She’s only tolerated sips of water and juices. Since she’s also been unable to eat, she hasn’t taken any insulin as directed. While helping A.M. from the lobby to the examining room you note that she’s unsteady, her skin is warm and flushed, and that she’s drowsy. You also note that she’s breathing rapidly and smell a slight sweet/fruity odor. A.M. has a challenge answering questions but keeps asking for water to drink.

You get more information from A.M. and learn the following:
• She had some readings on her glucometer which were reading ‘high’
• She vomits almost every time she takes in fluid
• She hasn’t voided for a day but voided a great deal the day before
• She’s been sleeping long hours and finally woke up this morning and decided to seek care

Vital Sign
Temperature 101.3° F (tympanic)
Blood pressure 88/46 mmHg
Heart rate 132 beats/minute
Respiratory rate 36 breaths/min, deep
Oxygen saturation % (SpO2) 91% on room air

Lab results
Serum glucose 657 mg/dl
Serum potassium 6.2 mEq/L
Urine ketones Positive

1. What is the disorder and its pathophysiology that you expect the health care provider to diagnose and treat?
2. Describe the etiology of the disorder A.M is experiencing.
3. Identify and describe the clinical manifestations of the disorder A.M. is experiencing.
4. Identify and describe the expected treatment options for A.M. based on the disorder and clinical manifestations.

Sample Solution

2. Builds trust and transparency: Adherence to ethical principles fosters trust from stakeholders and ensures transparency in the analytical process.

3. Improves decision-making: Ethical considerations promote responsible use of data and findings, leading to more informed and well-rounded decisions.

4. Upholds legal and social norms: Ethical analysis ensures alignment with relevant laws and regulations, as well as broader societal values.

5. Promotes sustainability and long-term benefits: Ethical practices contribute to building sustainable and impactful outcomes from analysis.

Philosophical Approaches to Ethical Decision-Making:

Here’s a breakdown of the three main approaches you mentioned:

1. Consequentialism:

  • Focus: Maximizing good and minimizing harm for the greatest number of people.
  • Application in analysis: Weighing the potential positive and negative impacts of different analytical approaches and choosing the one with the best overall outcome.
  • Criticism: Difficulty predicting exact consequences, overlooking individual rights, potential for manipulation.

2. Deontology:

  • Focus: Following universal moral rules and principles, regardless of consequences.
  • Application in analysis: Adhering to principles like fairness, justice, and respect for privacy, even if it affects overall outcomes.
  • Criticism: Difficulty applying abstract principles to complex situations, potential for rigidity and inflexibility.

3. Virtue Ethics:

  • Focus: Developing good character traits like honesty, courage, and wisdom to guide decision-making.
  • Application in analysis: Cultivating virtues within analysts and organizations to ensure ethical analysis practices.
  • Criticism: Subjectivity in defining and cultivating virtues, potential for cultural biases.

Choosing the Right Approach:

No single approach is perfect, and the most ethical decision-making often involves combining elements from all three:

  • Consequentialism helps assess potential impacts.
  • Deontology provides a framework of moral principles.
  • Virtue Ethics focuses on developing responsible individuals and organizations.

Ultimately, the decision on which approach to prioritize depends on the specific context and values of the analysis. Consider factors like the stakeholders involved, the nature of the data, and the potential risks and benefits.

Remember, ethical analysis is an ongoing process, and regular reflection and adaptation are crucial for making responsible and impactful decisions.No, Donna should not treat Mary for her disordered eating. While Donna is a licensed professional counselor, treating eating disorders requires specialized training and expertise that she currently lacks. Here’s why:

Reasons why Donna shouldn’t treat Mary:

  • Lack of specialized training: Disordered eating is a complex medical and psychological condition requiring specific knowledge and treatment approaches. Donna’s general counseling training, even coupled with experience with one case of emotional eating, doesn’t qualify her to handle the intricacies of various eating disorders.
  • Potential for harm: Misdiagnosis, inappropriate treatment, or failure to recognize medical complications can cause significant harm to Mary’s physical and mental health.
  • Ethical violations: It’s unethical for Donna to practice outside her scope of competence, potentially breaching her professional code of ethics and risking disciplinary action.

What Donna should do:

  • Refer Mary to a qualified eating disorder specialist: This involves identifying licensed professionals with relevant training and experience in treating eating disorders. Donna can search provider directories, consult colleagues, or reach out to professional organizations for recommendations.
  • Inform Mary about the need for specialized care: Explain to Mary why she needs treatment from an eating disorder specialist and provide a list of potential referrals. Answering Mary’s questions and offering support throughout the referral process demonstrates professionalism and care.
  • Maintain appropriate boundaries: While referring Mary, Donna can offer general support and help navigate the healthcare system, but she should avoid providing any specific treatment or advice related to eating disorders.

Considerations classmates might not have mentioned:

  • Legal implications: In some states, treating eating disorders without proper qualifications might constitute practicing medicine without a license, leading to legal repercussions.
  • Insurance coverage: Mary’s insurance might not cover treatment from a non-qualified provider, creating financial burdens.
  • Impact on trust and reputation: Taking on a case beyond one’s competence can damage trust with clients and negatively impact professional reputation.

Donna prioritizing Mary’s well-being and ethical practice by referring her to a qualified specialist demonstrates responsible and ethical decision-making, ultimately benefiting Mary’s recovery journey.

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